Lumbar stenosis and systemic diseases: is there any relevance?

A retrospective study of spinal stenosis patients admitted to Assaf Harofeh Medical Center Orthopedic Departments.

To assess any correlation between systemic disease and spinal stenosis.

Lumbar stenosis is a common spinal disease with various etiologies. No findings have been reported correlating spinal stenosis incidence with background diseases, although diabetes mellitus (DM) has been found to play a role in intervertebral disc degeneration and spondylolisthesis.

Hospitalization records of patients with spinal stenosis admitted to Assaf Harofeh Medical Center Orthopedic Departments between 1984 and 1993 were checked for background diseases, age, and sex. The data collected were statistically evaluated for any correlation between spinal stenosis and chronic diseases and compared with the data published by the "Israeli Bureau of Statistics" and Israel's largest Health Maintenance Organization's chronic disease survey.

Of 537 patients with spinal stenosis 57% (308) were males and (229) 43% females with an average age of 60+/-14 years. Diseases occurring with a high incidence were hypertension (HTN)-23.2% (compared with 7.8% in the general population), DM-13.6% (5.9%), ischemic heart disease (IHD)-11.9%, and hyperlipidemia-4.4%. Patients with spinal stenosis had no significant age and sex distribution difference compared with the general population and no such difference was found for patients suffering from HTN, IHD, or DM. Isolating the effect of DM on HTN and IHD revealed that HTN was a primary disease whereas IHD was secondary to DM with significant statistical validation (P=0.003).

To the best of our knowledge this is the first study linking spinal stenosis and DM or HTN. It was found that chronic diseases do not alter the natural age and sex distribution of spinal stenosis. The major question remaining concerns the biologic mechanism linking spinal stenosis and DM or HTN.